Uterine rupture during pregnancy.

Abstract

BACKGROUND: Despite great advances in modern obstetrics, uterine rupture (UR) remains one of the most frightening complications with high morbidity and mortality. OBJECTIVE: To improve the diagnosis and management of UR. RESULTS: We report two cases of UR. Case 1 was spontaneous UR and case 2 was associated with a scar in the patient's uterus. Interestingly, the ruptured scar was not a scar from a previous cesarean section; it was a scar that was associated with placenta accreta. The fetal heart rates in both cases were below 80 beats per minute after UR. The newborn in case 1 died soon after delivery, while the newborn in case 2 survived. Both women were healthy and were discharged from hospital two to three weeks after surgery. CONCLUSION: UR can occur in a previously unscarred uterus or from a scar of a cesarean section or scars caused by other pathologic lesions in the uterus. Severe fetal bradycardia might be a strong indicator for UR. Such study will help obstetricians provide more careful measures to manage UR, so that its morbidity and mortality can be decreased.